WEDNESDAY, Jan. 7 (HealthDay News) -- A mutation in leukemia cells predicts which children with acute lymphoblastic leukemia are more likely to relapse.

The discovery, reported online Jan. 7 in the New England Journal of Medicine, might lead to tests to help physicians fine-tune treatment for different subsets of patients.

"The treatment of acute lymphoblastic leukemia (ALL) is really one of the success stories in American and international medicine in that close to 80 percent of patients can be cured with an intensive and prolonged chemotherapy regimen," said Dr. Arthur Frankel, a professor of medicine at the Texas A&M Health Science Center College of Medicine, who was not involved with the study.

"Having said that," Frankel added, "there are two changes that would improve the quality of care and maybe improve quality of life and the cure rate. One is that you'd like to identify patients that don't need this two years of aggressive chemotherapy. At the same time, there is a need for identifying early those children and adults that would do very poorly and trying to come up with new treatments."

ALL, or cancer of white blood cells called leukocytes, is the most common pediatric cancer.

Although current therapies are effective in a majority of pediatric patients, they can be hard to endure. And still, about 20 percent of patients will relapse, and only about a third of those who relapse will survive beyond five years.

Scientists have already identified a number of genetic mutations and deletions in genes (including the one that's the subject of the new report, IKAROS) that regulate the normal development of leukocytes, said study senior author Dr. James R. Downing, scientific director of St. Jude Children's Research Hospital, in Memphis, Tenn.

"But in prior studies, we never really saw any association with outcome," Downing said.

Downing and his colleagues conducted gene analyses of 221 children with high-risk ALL who were being treated for the disease as part of another study.

Deletions or changes in the IKAROS gene (of which there were several) that were found in slightly more than one-quarter of the patients were associated with a worse outcome. The findings were validated in a second group of 258 children.

IKAROS produces the IKAROS protein, which is involved in regulating other genes.

"The mutations of IKAROS were shown to be independent prognostic indicators, they had high value to identify patients at high risk of relapse over and above known risk factors," Downing said. "Identification of these lesions at the time of diagnosis would provide new information to better identify those patients."

It's unknown how the gene works at this point, but Downing speculated that it has to do with the gene's role in regulating the formation of lymphocyte cells.

Diagnostic tests need to be developed before the study results -- which also need to be replicated -- can be of benefit to patients, the researchers said.

There's another potential benefit down the road: new information to help find new targets for drugs.

More information

Visit the U.S. National Cancer Institute for more on ALL in children.

MONDAY, Jan. 5 (HealthDay News) -- Obese postmenopausal women who have never used hormone replacement therapy may face an increased risk of ovarian cancer, compared to normal-weight women, a new study suggests.

Interestingly, obese women who have used hormone replacement therapy (HRT) for symptoms of menopause may not face increased risk for this type of malignancy.

The study findings are published in the Feb. 15 issue of the journal Cancer.

The take-home message is a familiar one, experts said: Maintain a healthy body weight.

"This is another, very fine epidemiologic study that shows a relationship between obesity and female-related cancers," said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. "The two leading causes of cancer in the western world today are tobacco and obesity. We've made enormous progress with tobacco-related malignancies -- it's really stunning. The next wave is obesity-related illness."

Added Dr. Elizabeth A. Poynor, a gynecologic oncologist at Lenox Hill Hospital in New York City, "This is yet another health risk that we can talk about with women who are overweight, and yet another reason to lose weight."

Ovarian cancer is the fifth leading cancer killer of U.S. women and the leading killer among gynecologic malignancies. Only about 37 percent of women with this diagnosis will survive beyond five years, according to background information in the study.

Women who've had children and who've used oral contraceptives appear to have a decreased risk of the disease.

A family history of ovarian cancer along with HRT use is known to contribute to the risk, and there has been some evidence that excess body weight also ups the risk.

For the new study, investigators from the U.S. National Cancer Institute followed almost 95,000 U.S. women, aged 50 to 71, for an average of seven years.

Overall, obese women -- those with a body mass index (BMI) or 30 or above -- had a 26 percent higher chance of developing ovarian cancer than women of normal weight, a figure the researchers said was not statistically significant.

However, the picture was somewhat different among subgroups of women. Obese women who had never used hormone therapy had an 80 percent higher risk of developing ovarian cancer, compared with their normal-weight counterparts. There appeared to be no relationship between BMI and ovarian cancer among women who had used hormone therapy for menopausal symptoms.

Obese women without a family history of the disease had a 36 percent higher risk of developing ovarian cancer, although there was no heightened risk in obese women who did have a family history.

According to the study authors, the findings indicate that obesity may increase ovarian cancer risk through hormonal effects. Specifically, excess fat increases production of estrogen, which may spur the growth of ovarian cancer.

But the picture is likely much more complicated than that, said Dr. Michael A. Bookman, vice president for ambulatory care and clinical research at Fox Chase Cancer Center in Philadelphia.

Overall, obese women in the study did not have a notably higher risk for ovarian cancer. The increased risk was only seen in a subgroup of the women, he noted.

"When you do a subset analysis, there's always a risk," Bookman said. "They wave their hands and think maybe this is because estrogen is bad for you, but there are a lot of other things obesity does than create endogenous estrogen, like other growth factors.

"It's interesting that, in women who were exposed to menopausal hormones, there was some evidence that [hormones] actually protected them," he added. "It's, at best, a modest effect and not nearly as strong as the data with endometrial cancer. I'm not a fan of obesity, but I think, in this particular analysis, it's a pretty modest effect. It would be much more convincing if it were significant for the entire population."

Study lead author Dr. Michael Leitzmann, of the National Cancer Institute, said one "possible reason for the observation that obesity might lead to increased ovarian cancer risk in women who have not used HRT versus women who have is that exogenous estrogens supplied by menopausal hormones fail to add further to the high background levels of endogenous estrogens among obese women."

More information

The U.S. National Cancer Institute has more on ovarian cancer.

MONDAY, Dec. 15 (HealthDay News) -- Despite major progress reducing overall colorectal cancer incidence and death rates in the United States, black men and women are still 45 percent more likely than whites to die of the disease.

That finding was contained in a report released Monday by the American Cancer Society.

The Colorectal Cancer Facts & Figures 2008-2010 report -- the second edition of a report first issued in 2005 found that colorectal cancer incidence and deaths continue to decrease among both blacks and whites, but rates remain higher and declines have been slower among blacks. In fact, the gap between blacks and whites has actually increased over the past few years, the report said.

For example, the previous report found the colorectal cancer incidence rate was 63.1 per 100,000 among white men and 72.9 per 100,000 among black men, a difference of 9.8. The new report said the incidence rate is now 58.9 per 100,000 among white men and 71.2 per 100,000 among black men, a difference of 12.3.

However, the report also found many signs of overall progress. Since the last report was released, 10 more states have enacted legislation ensuring coverage for the full range of colorectal cancer screening tests, bringing the total to 26 states plus Washington, D.C.

Among other advances: the proportion of colorectal cancers diagnosed at a localized stage has increased among most racial and ethnic groups; and the U.S. Food and Drug Administration has approved a new targeted monocolonal antibody therapy (panitumumab) to treat metastatic colorectal cancer, the report said.

"We've made remarkable progress in reducing death and suffering from colorectal cancer," Elizabeth T.H. Fontham, of Louisiana State University and national volunteer president of the American Cancer Society, said in a new release. "Tests we have right now allow doctors to detect this killer at its earliest, most treatable stage, or even prevent it altogether. But as this report shows, there's more work to be done to ensure all Americans have access to these lifesaving tests, and that those who do have access to the tests use them."

In 2008, an estimated 148,800 people in the United States will be diagnosed with colorectal cancer and about 49,000 will die of the disease, which is the third most commonly diagnosed cancer and the third leading cause of cancer death in the country, according to the American Cancer Society.

Many of those cancers and deaths could be prevented through more widespread use of cancer prevention methods and by increasing access to screening tests.

More information

The U.S. National Cancer Institute has more about colorectal cancer.

FRIDAY, Dec. 5 (HealthDay News) -- A diagnosis of prostate cancer may prompt an understandable feeling of dread, but patients actually have a wide array of options at their disposal for tackling the disease, medical experts say.

There are so many options that a man's quality of life should be considered strongly when weighing various procedures. In fact, a growing number of doctors say many prostate cancers are better off being left untreated.

"It's been said that more men die with prostate cancer than of prostate cancer," said Dr. Durado Brooks, director of prostate cancer for the American Cancer Society. "For a significant number of these men, if they have other health problems that are likely to shorten their life span, in many instances they aren't likely to live long enough for the prostate cancer to cause them any problem."

The survival rate of prostate cancer is very high. Overall, 99 percent of men diagnosed with prostate cancer survive at least five years, according to the American Cancer Society.

Furthermore, 91 percent of all prostate cancers are found while they are still within the prostate or only in nearby areas. The five-year relative survival rate for those men is almost 100 percent.

"Prostate cancer is very survivable," said Dr. Terry Mason, commissioner of the Chicago Department of Public Health and a volunteer member of the American Cancer Society Prostate Cancer Advisory Group. "It's a very treatable disease."

But depending on the type of treatment selected, a prostate cancer patient can suffer some rather uncomfortable side effects, among them impotence and incontinence.

Surgery that removes the tumor can result in impotence, if the nerves that control erection are damaged during the procedure, according to the U.S. National Cancer Institute. The patient also could suffer short-term incontinence while he recovers from surgery.

Radiation treatment can cause both bladder and bowel incontinence. It can also lead to impotence, although that effect does not take place immediately.

"Men may start out being sexually active, and then as the radiation scarring and damage develops over the next two to three years, there's a gradual decrease in the levels of potency," Brooks said. "With surgery, it's the opposite. There is some initial difficulty, and then things improve over time."

Within each type of treatment, there's also a menu of options with an array of pluses and minuses.

For example, surgical patients can opt for a "nerve-sparing" procedure less likely to interfere with sexual function. And radiation patients can choose between external beam treatment and brachytherapy, in which radioactive "seeds" are implanted in the tumor, according to the American Cancer Society.

"There is no proven best treatment," Brooks said. "They need to investigate all the treatment options, and understand all the up sides and potential complications from each option."

A patient also might decide that it's just not worth getting treated, particularly if the tumor is slow-growing.

In a tactic called "watchful waiting," the patient does not receive treatment. Instead, regular checkups monitor the progress of the cancer.

If the man's life expectancy is low due to old age or other factors, surgery or radiation for prostate cancer might actually do more harm than good, some doctors feel.

"I have that conversation a lot with the older gentlemen, particularly those guys over 75 years old," Mason said. "Those are the guys who really have to weigh whether it's worth it."

New vaccine therapies to attack prostate cancer could be on the horizon, Brooks said. There are two or three vaccines under development that would prompt a patient's immune system to target cancer cells.

A phase 1 trial of one vaccine appeared to promote immune responses in 70 percent of the patients involved, according to a recent study.

However, Mason said those drugs are still many years and many, many dollars away.

In the meanwhile, there are steps men can take to limit their chances of getting prostate cancer.

For example, some studies have shown that chemicals released from muscle proteins when they're cooked at high temperatures could increase risk of prostate cancer in some, Mason said.

Other studies have shown that a diet rich in animal fat or meat could be linked to incidence of prostate cancer, according to the National Cancer Institute.

"Before I would put my money in a vaccine, I would want to think about some of the dietary things people can do," Mason added.

More information

To learn more visit the U.S. National Cancer Institute.